Limb lengthening

What is bone lengthening?

Bone lengthening, also known as bone elongation, encompasses a series of surgical techniques whose objective is to increase the length of a bone segment.

Why is it done?

Bone lengthening is performed bilaterally in all cases of short stature and unilaterally, in cases of limb inequality. The aim is to ensure that the patient can have a normal gait when walking and does not place undue stress on any particular part of the body.

What does it consist of?

Bone lengthening is usually achieved with techniques that involve cutting the bone (osteotomy and corticotomy) and progressively lengthening the repair callus that occurs in the natural attempt to repair fractures. The newly regenerated bone is achieved by "stretching" the repair callus once the repair has begun. This generates a new bone in continuity with that of the patient.

To perform this progressive lengthening it is necessary to use mechanical devices, extraosseous (external fixation systems) or intraosseous (intramedullary nails). Implantation of such devices can be performed with local anaesthesia.

Preparing for bone lengthening

You are likely to stay in hospital for 2-4 days for each procedure, so it is important to prepare by:

• wearing loose-fitting clothes which can fit over the frame that is installed
• bringing books or a tablet for your stay in hospital
• scheduling the required time off work
• arranging for someone to take you to and from the hospital

Post-operative care

After surgery you will be given advice on the best position to keep your leg to avoid problems with your joints, and you will start to learn how to walk with the frame provided with the help of a physiotherapist.

After a few days you will be able to remove the bandages and shower your legs or arms. When you are discharged from hospital you will be given pain medications and further physical therapy to keep moving the muscles and joints in the affected limb. During the healing period, it is important to:

• avoid smoking or medication such as aspirin
• avoid swimming in a hot tub, lake or the open sea
• eat a healthy, well-balanced diet with plenty of calcium

Every 7-10 days you will need to readjust the frame to continue lengthening the bone, and continue exercising to promote healing. Eventually, when the bone has reached its desired length you will visit hospital again to have the frame removed and a cast applied to protect the new bone.